It’s easy to wonder how world leaders, journalists, religious figures and ordinary citizens looked the other way while six million Jews were killed in the Holocaust. And it’s even easier to assume that we’d do better. But so far the brutal war here in eastern Congo has not only lasted longer than the Holocaust but also appears to have claimed more lives. A peer- reviewed study put the Congo war’s death toll at 5.4 million as of April 2007 and rising at 45,000 a month. That would leave the total today, after a dozen years, at 6.9 million.

What those numbers don’t capture is the way Congo has become the world capital of rape, torture and mutilation, in ways that sear survivors like Jeanne Mukuninwa, a beautiful, cheerful young woman of 19 who somehow musters the courage to giggle. Her parents disappeared in the fighting when she had just turned 14 — perhaps they were massacred, but their bodies never turned up — so she moved in with her uncle. A few months later, the extremist Hutu militia invaded the home. She remembers that it was the day of her very first menstrual period — the only one she has ever had “First, they tied up my uncle,” Jeanne said. “They cut off his hands, gouged out his eyes, cut off his feet, cut off his sex organs, and left him like that. He was still alive.

“His wife and his son were also there. Then they took all of us into the forest.” That militia is known for kidnapping people and enslaving them for months, even years. Men are turned into porters, and girls into sex slaves. Jeanne and other girls were regularly tied spread-eagle and gang-raped, and she soon became pregnant. The rapes continued, sometimes with sticks that tore apart her insides and left her dribbling wastes constantly. Somehow the fetus survived, but her pelvis was too immature to deliver the baby.

One of the people the militia had kidnapped was a doctor who was forced to treat the soldiers. The doctor, seeing that Jeanne was close to dying in obstructed childbirth, cut her open with an old knife, without anesthetic, and removed the stillborn baby. Jeanne was delirious and almost dead, so the militia dumped her beside a road.

“She was completely destroyed inside,” said another doctor, Denis Mukwege, who saved her life after she was brought here to Bukavu. Dr. Mukwege, 54, presides over the 400-bed Panzi Hospital <http://www.panzihospitalbukavu.org/> , supported by the European Union and private groups like the Fistula Foundation. He is sometimes mentioned as a candidate for the Nobel Peace Prize for his heroic efforts to fight the war and heal its victims.

Dr. Mukwege operated on Jeanne nine times over three years to repair the fistulas that were causing her to leak wastes. Finally he succeeded, and she returned to her village to live with her grandmother.

“He told me to stay away from men for three months,” Jeanne remembers, to give her body time to heal. But three days after she returned to the village, the militia came again and raped again. The fistula reopened. Jeanne, kept naked in the forest and stinking because her internal injuries had reopened, finally managed to escape and eventually found her way back to Panzi Hospital. Dr. Mukwege has already started a second round of surgeries on her, but there is so little tissue left that it is not clear she can ever be continent again.

About 12 percent of the raped women he treats have contracted syphilis, and 6 percent have H.I.V. He does what he can to repair their injuries and help them heal — until the next time.

“Sometimes I don’t know what I am doing here,” Dr. Mukwege said despairingly. “There is no medical solution.” The paramount need, he says, is not for more humanitarian aid for Congo, but for a much more vigorous international effort to end the war itself.

That means putting pressure on neighboring Rwanda, a country so widely admired for its good governance at home that it tends to get a pass for its possible role in war crimes next door <http://www.nytimes.com/2008/12/04/world/africa/04congo.html?_r=3&pagewanted=1> . We also need pressure on the Congolese president, Joseph Kabila, to arrest Gen. Jean Bosco Ntaganda, wanted by the International Criminal Court on war crimes charges. And, as recommended by an advocacy organization called the Enough Project <http://www.enoughproject.org/conflict-minerals> , we need a U.S.-brokered effort to monitor the minerals trade from Congo so that warlords can no longer buy guns by exporting gold, tin or coltan.

Unless we see some leadership here, the fighting in Congo — fueled by profits from mineral exports — will continue indefinitely. So if we don’t act now, when will we? When the toll reaches 10 million deaths? When Jeanne is kidnapped and raped for a third time?